MedicaidPrior AuthMedium impact
HASA 22-21
Michigan Medicaid - MDHHS·MI · Pediatrics·Provider Bulletin
Effective date
Aug 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan Medicaid now allows prior authorization for return transfers of stabilized NICU infants back to community hospitals, requiring PACER approval from ACRC for elective transfers with neonatologist written orders. This enables continued care closer to families while maintaining existing hospital and ambulance reimbursement methodology.
Action Required
Before August 1, 2022: Hospitals with NICU services must update transfer protocols to obtain PACER prior authorization from ACRC for elective return transfers of stabilized infants. Ensure neonatologists provide written transfer orders specifying transfer is for bonding, teaching, and growth. Update billing procedures to use existing DRG daily rate methodology for transferring hospitals and full DRG payment for receiving hospitals based on discharge status.